Key Goal

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(No Transcript)
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Key Goal

• Connected Kids Safe Strong Secure is an AAP
  program designed to support clinicians efforts
  to prevent youth violence by promoting the
  development of resilient children.

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Why Is This Important?

• Violence is a major cause of childhood morbidity
  and mortality in the United States.
• Homicide is the 2nd leading cause of death for
  13- to 21-year-olds
• The leading cause of death for African Americans
  13 to 21 years old1
• Increase in community violence during 1990s
• 21st century rates in the United States still
  among the highest in the world

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Why Is This Important?

• Many parents and pediatricians feel community
  violence screening should be routine in well
  child care.2-5
• Results from the 1998 and 2003 AAP Periodic
  Surveys of Fellows show that a majority of
  pediatricians feel unprepared to manage community
  violence.2-4

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Why Is This Important?

• Parents want more doctors to discuss community
  violence.5
• Results from the National Survey of Early
  Childhood Health

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Connected Kids provides

• Tools and strategies to help parents raise
  resilient children
• Educational materials for parents and youth
• Effective anticipatory guidance
• Developmentally appropriate guidelines
• Easy-to-use Clinical Guide with links to research

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Development Process

• Development of Connected Kids included6
• Input from parents, clinicians, and other experts
• Testing of program materials in focus groups with
  diverse families and clinicians7
• Incorporation of stakeholder feedback
• A broad and respectful approach for all of the
  educational materials
• Coordination with other AAP efforts

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Objectives

• Connected Kids will
• Strengthen the connections among children and
  youth, their families, and their community
• Reduce risk factors by building resilience8

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Presentation Goals

• 1. Become familiar with the underlying
  theoretical model for Connected Kids
• 2. Review the counseling schedules for Infancy
  and Early Childhood, Middle Childhood, and
  Adolescence
• 3. Learn how to prepare a strategy for
  implementing this program in your practice

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Connected Kids . . .

• Uses an asset-based approach to prevention that
• Emphasizes the identification and enhancement of
  strengths
• Enhances clinician-family alliance
• Helps parents with strategies to
• Promote positive development
• Develop prosocial interpersonal skills
• Obtain support and resources to help raise
  children

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Asset- Versus Risk-based Approaches to Guidance

• Assets
• Goal Help improve childs resilience
• Assess family strengths
• Link to community resources

• Risks
• Goal Reduce known risks
• Screen for risk factors
• Refer to services

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Connected Kids Includes

• Clinical guide
• Counseling schedule
• Handouts for parents and families
• Web site
• This training presentation
• Database of violence prevention materials
• Success stories

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Clinical Guide

• This presentation supplements the clinical guide,
  available online at www.aap.org/ConnectedKids
• Clinical guide contains
• Background information
• Counseling schedule
• Visit-by-visit suggestions from birth to age 21

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Building Blocks
Connected Kids centers on 4 overlapping themes of
anticipatory guidance
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Child-Centered

• Recognizes
• Childs changing abilities
• Cognitive development of child
• Related parental concerns

Parent- Centered
Community Connections
Physical Safety
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Parent-Centered
Child-Centered

• Addresses the importance of parental supports
• Incorporates the idea that parents develop along
  with the child
• Contributes to the quality of family life
• Promotes positive parenting

Community Connections
Physical Safety
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Positive Parenting
Teaching desired behavior begins with a positive
and nurturing foundation9
What to do when your child misbehaves
How to manage conflict and teach responsibility
Ways to nurture your children and prevent
misbehavior
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Community Connections
Child-Centered

• Research underscores the importance of10
• Social capital a measure of the
  interconnectedness among people with their
  community
• Community connections
• Clinicians can help connect families to community
  resources

Parent- Centered
Physical Safety
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Physical Safety

• Counseling schedule focuses on violence and
  intentional injury
• Complements AAPs TIPP
  (The Injury Prevention Program)
• Handguns in the home placed in the context of
  child development
• Provides objective information to help families
  make their own decisions

Parent- Centered
Community Connections
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Connected Kids Counseling Schedule

• Lists topics to introduce and reinforce at each
  visit
• Provides asset-based assessment and anticipatory
  guidance for each visit
• Links to use of parent and patient brochures
• Distributed when a topic is first introduced
• Promote discussion between provider and family
• Give useful information to foster the development
  of strong, resilient children

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Counseling Schedule
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Anatomy of a Brochure

• Front Cover
• Cover image visually conveys core message
• Designed by Artists for Humanity, a non-profit
  arts and entrepreneurship program for Boston
  teens.

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Anatomy of a Brochure

• Content
• Each brochure addresses one specific issue
• Content based on all four building block themes
• Reading level 2nd to 6th grade
• Contains concrete examples for key concepts

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Anatomy of a Brochure

• Back Cover
• Summarizes topics
• Space provided for
• Parent/patient guidance
• Follow-up suggestions
• Community resources
• Next appointment
• Practice name and address

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Counseling Schedule
Infancy Early Childhood 2 days 4 years
Middle Childhood 5 10 years
Adolescence 11 21 years
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Counseling Schedule Infancy
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Infancy11-17

• Early caregiver relationships set the stage for
  future relationships
• Securely attached young children have an easier
  time developing positive, supportive
  relationships
• Emerging evidence shows that securely attached
  young children are found to have more18-25
• Balanced self-concept
• Advanced memory processes
• Sophisticated grasp of emotion
• Positive understanding of friendship

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Infancy Counseling
Is this what you expected?
Be on the lookout for families who are socially
isolated or experiencing family discord.
Who helps you with your baby?
How much time do you have off from work?
If there is a gun in the home, how is it stored?
Being a new parent can be exhausting. How are
you doing?
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Infancy Brochures
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Welcome to the World of Parenting!Visit 2 Days
to 4 Weeks

• Helps parents understand the normal development
  of newborns
• Provides information about coping skills for
  parents
• Discusses changes in the ways parents may now
  relate as a couple

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How to Use this Tool

• Whenever appropriate, include both parents in the
  conversation
• Discuss infant crying and ways to handle it
• Crying is normal
• Crying upsets parents
• Sometimes, parents just need to let the baby cry

Helpful Hint!
I love the way your baby looks at you, soothes to
your voice. Youre doing a great job!
Support new parents with positive statements
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Parenting Your InfantVisit 2 and 4 Months

• Helps parents understand normal development of 4-
  to 9-month-old infants
• Stresses importance of building family
  connections
• Discusses 3 problems
• Colic
• Trouble sleeping
• Clinging to parents

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How to Use this Tool

• Reiterate messages about crying and parental
  frustration
• Emphasize to parents the importance of having
  time together without their baby

Helpful Hint!
Support new parents with positive statements
Your infant is alert, growing well, and has a
beautiful smile!
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How Do Infants Learn?Visit 6 and 9 months

• Offers practical suggestions to parents based on
  a newborns brain development
• Encourages activities like reading or singing to
  promote brain growth
• Helps parents understand that exploration is a
  natural developmental need

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How to Use this Tool

• Ask parents about their social connections. Refer
  to sections Others Who Care for Your Baby and
  Taking Care of Yourself
• Utilize the Social Connections worksheet from
  the Clinical Guide
• Talk about child care arrangements

Helpful Hint!
Wow, your baby is really interested in my
stethoscope! I like the way she lets me examine
her, but she is always looking over at you for
assurance.
Notice infants new behaviors and parent-child
interaction
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Your Child is on the Move Reduce the Risk of
Gun InjuryVisit 6 and 9 months

• Correlates childhood injuries/ deaths due to
  firearms and presence of handguns in the home
• Emphasizes that a childs curiosity about guns
  overwhelms any lessons learned about gun safety
• Provides information needed to make informed
  decisions

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How to Use this Tool

• Discuss handguns in the context of other
  household hazards
• Since some parents may not be in agreement
  concerning the presence of handguns in the home,
  encourage them to look at the brochure together
  to make an informed decision

Helpful Hints!

• In areas of country with high rates of gun
  ownership, some practices offer reduced price or
  free gun locks
• Be aware of the potential lethality of domestic
  violence in homes with handguns

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Counseling Schedule Early Childhood
INTRODUCE
VISIT

• Child Development and
• Behavior

12 and 15 MONTHS

• Childs Assets
• Guided Participation
• Media

18 MONTHS and 2 YEARS

• Peer Playing
• Safety in Others Homes
• Talking About Emotions
• Promoting Independence

3 and 4 YEARS
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Early Childhood26-30

• Communication skills allow young children to
  sustain bouts of play
• How young children learn to react is greatly
  influenced by
• Parental relationship
• Parental behavior
• Home environment

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Early Childhood Counseling
Normal toddler behavior may be especially
difficult for families with little social support.
Encourage alternatives to TV, such as outdoor
activity or reading.
She really pays attention when we talk does she
understand when you speak to her?
Does your child have opportunities to play with
other children this age?
Teach your child by providing positive
reinforcement for desired behaviors.
What do you think your child does best? What
does he enjoy doing?
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Early Childhood Brochures
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Teaching Good Behavior Tips on How to
DisciplineVisit 12 and 15 Months

• Describes the basics of a behavioral approach to
  parenting toddlers
• Positive reinforcement for desired behaviors
• Limit setting
• Advises parents about effective alternatives to
  corporal punishment

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How to Use this Tool

• Start conversations about toddler behavior with
  gentle inquiries
• Your child is growing and developing well. Have
  tantrums started? How do you handle them?
• What is your child doing new since last visit?
  What do you want to change?
• Endorse the core message a simple approach for
  teaching toddlers how to behave well

Be on the lookout for children with difficult
temperaments, families who are socially isolated,
and families experiencing discord
Helpful Hint!
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Playing is How Toddlers LearnVisit 18 Months
and 2 Years

• Helps parents understand normal toddler behavior
  and advises them how to
• Provide a stimulating environment during this
  period of major brain development
• Understand the natural curiosity and exploration
  of toddlers

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How to Use this Tool

• Discuss normal toddler play behavior
• Provide parents with guidance on the types of
  toys that stimulate imagination
• Help parents identify places where they can meet
  other toddlers and their parents

Helpful Hints!

• Check in with parents about how their family
  relationships are faring
• Support toddlers parents with positive
  statements

What a delightful child you have! He is really
curious about the world. This is great to see!
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Pulling the Plug on TV ViolenceVisit 18 Months
and 2 Years

• Provides information about the influence of TV
  violence on children
• Offers tips for parents
• Set limits on TV time
• Know what children are watching
• Watch programs with children
• Do not put TV in a childs room

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How to Use this Tool

• Identify alternatives to TV, such as toys that
  use imagination or outdoor play when possible
• Recognize that alternatives can be challenging,
  as TV often provides free in-home child care for
  families who cannot afford organized activities
  or who live in unsafe areas

Helpful Hint!
Whats your favorite TV show?
Ask the child
The childs response often indicates the kind of
TV programs being watched, which provides a topic
to open discussion with parents
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Young Children Learn A Lot When They PlayVisit
18 Months and 2 Years

• Introduces the importance of peer playing
• Includes tips on how to make play opportunities
  successful
• Assists parents in solving common difficulties,
  such as aggression and rejection

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How to Use this Tool

• Ask if child has opportunities to play with other
  children of the same age
• Use parents answer to discuss how the child
  plays or how to find other children
• Help parents problem solve any play or playmate
  issues

Helpful Hint!
I see you really like trucks. Do you and your
friends play with trucks a lot?
Try to notice something about what children are
wearing, the toys they bring, or their behavior
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Counseling Schedule Middle Childhood
INTRODUCE
VISIT

• Establishing Routines and Setting Limits

5 YEARS

• Teaching Behavior
• Bullying
• Out-of-School Time

6 YEARS

• School Connections
• Alcohol and Drugs
• Interpersonal Skills

8 YEARS

• Child Mental Health
• School Performance

10 YEARS
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Middle Childhood

• Rapid development of knowledge and skills
  characterizes middle childhood
• Routines and limits will help children feel loved
  and secure during this time of transition31,32
• Children learn by watching and interacting with
  parents, other adults, and other children
• Parents can consciously model and expect
  respectful behavior33,34

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Middle Childhood

• Play is another way children learn social
  skills35
• Many parents have concerns regarding safety and
  supervision for after-school activities
• Schools can have a significant impact on
  preventing violence36,37
• Besides academics, children learn how to function
  in society
• Parental involvement with schools improves their
  childrens experience and attachment

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Middle ChildhoodCounseling for the Parent
Children grow and develop within a context of
family, school, and community.
Do you have rules or limits with respect to TV,
video games, and computer time?
Are you involved in any school-related activities?
How does your child help around the home?
Who is your childs best friend?
Is your child happy most of the time or withdrawn?
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Middle ChildhoodCounseling for the Child
School-age children need to be active
participants in learning how to avoid and react
to conflict.
Have you been in any pushing or shoving fights?
What happens when you and your friends argue or
disagree?
What do you like best about school?
What do you do for fun?
If you see someone being bullied, what do you do?
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Middle Childhood Brochures
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Growing Independence Tips for Parents of Young
Children Visit 5 Years

• Emphasizes importance of beginning parent-child
  communication about peer relationships early
• Teaches parents how to
• Listen to children
• Help children assume more independence and
  responsibilities

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How to Use this Tool

• Address parents fears about childrens safety in
  the outside world
• Ask about how the child is doing in school and
  address any behavioral or emotional issues

Helpful Hints!

• Let the child know that secrets are not OK
• Discuss child sexual abuse during or after
  examination of the childs genitals

Im here with your mother so its OK. No adult
should ever tell you to keep a secret from your
parents.
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Bullying Its Not OK Visit 6 Years

• Provides guidance for parents of victims,
  bullies, and bystanders
• Victims may seek medical attention, but the
  poorest future outcomes are among bullies
  themselves38,39
• Schools can prevent bullying using proven
  interventions

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How to Use this Tool

• Place brochure in the waiting room it may be of
  interest to both parents and children
• Discuss specific strategies with those families
  whose children are being bullied
• Use brochure as a guide when speaking to
  community groups

Helpful Hint!
Have you ever been in any pushing or shoving
fights?
Ask the child
If the answer is yes, it is important to
determine the childs role.
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Drug Abuse Prevention Starts With Parents Visit
8 Years

• Discusses connection between a teens use and
  abuse of drugs and/or alcohol and
• Parent behavior and attitudes
• Media influences
• Communication
• Addresses parental role in modeling and
  maintaining open communication

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How to Use this Tool

• Encourage parents to talk with and listen to
  their children
• For parents who smoke, discuss the ease of
  starting and the difficulties of quitting
  address other substance abuse problems if
  apparent
• Have substance abuse resources on hand

Helpful Hint!
Did you hear about _____ being charged with
_____? What do you think about that?
Start conversations about drug abuse with the
recent news
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Friends Are Important Tips for Parents Visit 8
Years

• Focuses on importance of peer relationships
• Encourages parents to get to know their childs
  friends
• Provides guidance on monitoring behaviors to
  prevent unsafe activities
• Reiterates Connected Kids theme of clear,
  consistent, and positive communication

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How to Use this Tool

• Encourage parents to know their childs
  whereabouts and talk about expectations for
  staying in touch
• Encourage parents to help their child develop a
  sense of belonging through prosocial youth groups
  and community-based organizations

Helpful Hints!

• Address friendships and community activities
  while discussing school progress and promoting
  physical activity
• Ask parent Who is your childs best friend? to
  initiate discussion

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Everybody Gets Mad Helping Your Child Cope With
Conflict Visit 10 Years

• Developed for parents of pre- and early
  adolescents
• Describes the physiology of anger and offers
  strategies to avoid fighting when angry
• Guides parents in teaching their children how to
  respond to conflict

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How to Use this Tool

• Introduce the topic with general questions such
  as Are there a lot of fights at school? or
  What happens when you get angry?
• Discuss the bodys physical response to anger and
  how to stay calm

Helpful Hints!

• Ask patients who avoid fights if they have hints
  for other kids
• Consider the possibility of abuse, exposure to
  violence, or history of ADHD or minimal brain
  trauma in children who have difficulty dealing
  with anger

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Counseling Schedule Early Adolescence
VISIT
INTRODUCE
11 to 14 YEARS

• Family Time Together
• Peer Relationships
• Support System
• Staying Safe
• Teen Mental Health
• Conflict Resolution Skills
• Healthy Dating
• Gaining Independence

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Early Adolescence

• Independence is an overarching characteristic of
  the early teen years
• Becoming independent means being more responsible
  for ones own safety
• Help teens stay safe by teaching them how to
  avoid violence through good communication skills
• Effective communication is the common thread for
  the Connected Kids early adolescence counseling

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Early Adolescence

• Talk with teens and parents about activities that
  help families stay connected many teens are
  unsure about family relationships40
• Parents influence their teen children discuss
  parental use of alcohol, tobacco, and other drugs
• Involving adults from outside the family has a
  positive effect on teen development41
• Encourage teens to get involved in their
  communities it is one of the best ways to help
  them stay safe42

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Early Adolescence

• Teens with friends engaged in risky behaviors are
  more likely to imitate these behaviors43
• Conversely, friends involved in constructive,
  prosocial activities encourage healthy and safe
  behaviors
• Teen dating violence affects approximately 1 in 8
  high school students. Discuss healthy dating with
  both teens and their parents44
• Youth who have a variety of ways to solve
  conflicts are less likely to be hurt in a fight
  or arrested45

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Early Adolescence

• F I S T S
• Fighting
• Injuries
• Sex
• Threats
• Self-defense

• Use this mnemonic as the basis for assessing an
  adolescents risk for involvement in violence.
  See the Connected Kids Clinical Guide for more
  details.

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Early Adolescence Counseling for Parents
Address parents concerns about safety while
still helping them encourage their teens
independence
What do you think of your teenagers friends?
How are you monitoring your teenager?
How do you negotiate rules of behavior?
What kind of activities does your child enjoy?
What most concerns you about your teenagers
safety?
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Early Adolescence Counseling for Youth
With independence comes the responsibility for
staying safe.
Whom do you turn to for advice and encouragement?
Whom do you go to for help if youre having
trouble in your relationship?
What do you do to stay safe?
What after-school activities are you involved
with?
What do you and your friends like to do?
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Early Adolescence Brochures
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Talking With Your Teen Tips for Parents Early
Adolescence

• Describes typical teen behaviors and feelings and
  emphasizes parent-child communication as
  independence increases
• Teaches parents how to
• establish reasonable limits
• encourage safety as independence increases

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How to Use this Tool

• Initiate discussion at puberty by asking,Im
  sure there are many other changes going on that
  you cant see with your eyes, arent there?
• Speak with parents regarding concerns about their
  childs puberty

Helpful Hints!

• Having both teens and parents read this brochure
  may encourage better communication between parent
  and child
• Ask parents to think about their own adolescence
  and how they behaved and coped at this age

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Staying Cool When Things Heat Up Early Adolescence

• Encourages teens to think about ways to resolve
  conflicts other than fighting
• Discusses the role bystanders play in promoting
  violent behavior

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How to Use this Tool

• Use different approaches based on violence
  history
• Youre very healthy, but Im worried about all
  the fights youre getting into.
• Your exam looks good and Im also glad to hear
  that you havent been getting into a lot of
  fights.

Helpful Hints!

• Some clinicians leave this brochure in the
  waiting room for patients to read beforehand
• It may help to let patients know that this
  information came from other teenagers.

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Expect Respect Healthy Relationships Early
Adolescence

• Discusses healthy relationships and ways to
  recognize and prevent partner violence
• Teens are still experimenting with intimate
  relationships and may be more open to improving
  the quality of their relationships
• While designed for all teenagers, it had the most
  resonance with young female teens in focus groups.

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How to Use this Tool

• Introduce when teens show an interest in
  relationships, dating, and sexual behavior
• Discuss healthy relationships along with physical
  concerns such as sexually transmitted diseases
• Can be used with sex education courses in schools

Helpful Hints!
Today we have discussed some of the physical
issues of intimate relationships, but the
emotional issues are just as important.
At the end of an exam, say
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Teen Dating Violence Tips for Parents Early
Adolescence

• Discusses parental response when partner abuse is
  suspected
• The main concern for parents is their childs
  happiness and welfare, not pointing out what is
  wrong with the abusive partner

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How to Use this Tool

• Encourage parents to
• empathize with what their child is experiencing
• support their child in finding and maintaining
  non-abusive, healthy relationships

Helpful Hint!
Give this brochure to parents at the same time
Expect Respect Healthy Relationships is given to
teenagers
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Counseling Schedule Middle Adolescence
VISIT
INTRODUCE
15 17 YEARS

• Plans for the Future
• Firearms and Suicide
• Depression
• Resiliency

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Middle Adolescence

• There is a direct link between assets and the
  risk for violence and future success46
• Identify and support a teens
• strengths
• functional abilities
• positive relationships with others
• connections to groups, role models, and mentors

84
Middle Adolescence

• A key in helping teens avoid violence is to teach
  them how to
• assess risk and make an immediate decision
• think about the long-term consequences of that
  decision

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Middle Adolescence Counseling for Parents
Help parents with the teens dilemma of quick
decisions and long-term consequences.
If you have guns, how do you store them?
How do you stay in touch with your teen?
How is your teen getting along with friends?
Do you talk about future plans?
What non-school activities is your teen involved
with?
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Middle Adolescence Counseling for Youth
Teens are living in the moment, but need to think
about the future.
Do you have somebody to talk to when you feel sad?
What do you want to do after high school
graduation?
Can you get a gun if you want to?
What do you like best about yourself?
How do you get along with your friends?
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Middle Adolescence Brochures
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Teen Suicide and Guns Middle Adolescence

• Discusses the risks of guns in the home and the
  link to completed teen suicides
• Objectively discusses guns and gun storage

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How to Use this Tool

• Use on an individual basis to support counseling
• Can be distributed to schools and community
  groups
• Parents of teens with mood disorders may benefit
  from this along with the brochure Help Stop
  Teenage Suicide

Helpful Hints!
Did you hear about the teen who killed himself
last month? Im talking about this with all of my
teenage patients.
Use current events
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Connecting With Your Community Middle Adolescence

• Teenagers who are involved in their communities
  are less likely to be involved with
• alcohol
• drugs
• violence
• promiscuous sexual activity

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How to Use this Tool

• As relationships with their parents become more
  complex, additional adult role models become more
  important for teens
• Support teens in finding adults in the community
  who believe in and support them

Helpful Hints!

• Schools and community groups can help find
  opportunities that meet the interests and talents
  of young adults
• It may be beneficial for clinics to develop a
  resource guide for teens about local community
  groups

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Counseling Schedule Late Adolescence
VISIT
INTRODUCE
18 21 YEARS

• Transition to
• Independence
• Negotiating a New Environment
• (Post High School)

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Late Adolescence

• Transitioning to independence is a gradual
  process
• Bringing closure to this process is essential
• Many older teenagers are likely to be moving out
  of the home to
• higher education
• their own living situation
• an entirely new community
• This is exciting and stressful for both teen and
  parent

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Late AdolescenceCounseling for Youth
Support patients with the transition to becoming
a young adult.
What are your plans down the road?
Do you plan to move out of your parents home?
Whom do you talk to about your future plans?
Can I help with getting you where you want to go?
How do you feel about moving out?
95
Late Adolescence Brochures
96
Help Stop Teenage Suicide Late Adolescence

• Talks about common myths, gives the warning
  signs, and stresses that many teen suicides occur
  with little forethought
• Designed for teens, parents, and other caregivers

97
How to Use this Tool

• Use with patients with mental health issues,
  especially mood or conduct disorders, that often
  develop during these years
• Stress link between presence of a handgun and
  increased likelihood of lethal suicide attempts

Helpful Hint!

• Teens who think they may be gay, lesbian,
  bisexual, or transgender are at an increased risk
  for suicide help them and their families find
  additional support

98
Next Stop Adulthood Tips for Parents Late
Adolescence

• Teens are renegotiating parental relationships as
  they transition into adult responsibilities
• Helps parents let go while encouraging teens to
  seek guidance from their parents

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How to Use this Tool

• Use as a catalyst to discuss increasing
  independence
• Teens who are already in trouble may need a
  social worker to help better understand and
  implement these concepts

Helpful Hints!

• It is helpful to discuss employment, community
  service, sports, clubs, and other pursuits
• Teenagers need positive engagement with their
  outside community in order to thrive!

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Ideas for Optimal Use

• While implementing Connected Kids with an
  individual family depends on a familys starting
  pointand the familys interest in our inputwe
  can begin to consider some strategies for
  implementation in the following areas
• Intake Forms
• Counseling
• Educational Materials
• Practice Changes
• Community Connections

101
Intake Forms

• Use the Bright Futures Pediatric Intake Form
• Introduce Connected Kids in a cover letter to
  families
• Use information gathered to prioritize issues for
  families and tailor the program
• As your relationship with a family evolves, it
  may become easier to discuss sensitive topics
• Use the information gathered at every visit

102
Counseling

• Be sensitive to issues that might be difficult
  for a particular family
• Include both statistics and stories
• Prioritize topics covered on the families needs
• Use the adolescent brochures to facilitate new
  ways for parents and teens to talk

103
Educational Materials

• Use brochures to introduce sensitive topics, such
  as domestic violence
• Encourage the parent to share the information
  with other adults caring for the child
• Ask support staff to help distribute materials
  while patients are waiting to be seen

104
Educational Materials

• Personalize the brochures
• Circling or underlining a passage increases the
  likelihood that your advice will be followed
• Write down family-specific information in the box
  on the back cover during the visit
• Suggest placing it on the refrigerator so the
  cover image can be a reminder of what to do
• Encourage parents/patients to write questions in
  the box on the back while they are waiting

105
Practice Changes

• Involve all office staff receptionists observe
  how parents and children interact
• Use the Counseling Schedule from the Clinical
  Guide to document when you have introduced and
  reinforced topics
• Talk with colleagues about how they have
  successfully implemented Connected Kids

106
Community Connections

• Become familiar with programs in your community
• If resources do not exist, advocate for services
• Get involved
• Join coalitions working to rid the community of
  violence
• Speak to community and school groups
• Talk with the local media

107
In Summary

• All children deserve to grow up
• Safe
• Strong
• Secure
• We can help families achieve these goals!

108
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114
Acknowledgments

• Howard Spivak, MD
• Robert Sege, MD, PhD
• Elizabeth Hatmaker-Flanigan, MS
• Bonnie Kozial
• Vincent Licenziato
• Kimberly Bardy, MPH
• This project was supported by Grant No.
  2001-JN-FX-0011 awarded by the Office of Juvenile
  Justice and Delinquency Prevention, Office of
  Justice Programs, U.S. Department of Justice.
  Points of view or opinions in this document are
  those of the author and do not necessarily
  represent the official position or policies of
  the U.S. Department of Justice.